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Holly’s school, Underwood Elementary in Lee’s Summit, is on the line with an idea.

Meet-the-Teacher night is Monday. Given Holly’s emotional difficulties, how about instead of bringing Holly to Meet-the-Teacher night, Holly’s new second-grade teacher would love to have some one-on-one time at their home, say, on Tuesday?

Time was when Kim O’Neal might have considered the offer thoughtful. But at 37, having helped raise at least 16 foster kids and adopted five, she keeps her suspicion meter well-tuned.

“I guess they don’t want my kid there,” she said after the call. “Probably afraid Holly’ll throw a desk and scare the parents.”

Tuesday arrives, Aug. 22, one day before school starts. She’s watching Mrs. Sauve, an affable middle-aged teacher as light and thin as a spindle, sit on her carpet and read “Alice the Fairy” with a 7-year-old who, Kim’s convinced, “could knock her on her butt in a heartbeat.”

Debbie Sauve has no clue Kim’s annoyed. She just wants Holly to feel comfortable, to get to know her new teacher before the year starts.

One thought keeps coursing through Kim’s head:

Lady, you have no idea what you’re getting into.

•••

Educating children with severe emotional disturbances is a national problem, vexing teachers, districts and parents.

In 1975, Congress enacted a law that would eventually become IDEA, the Individuals with Disabilities Education Act, requiring states to provide disabled students with “free appropriate public education” in the “least restrictive environment.”

The law has been a boon. Six million disabled students each year are given IEPs (Individualized Education Programs) that qualify them for special services, education classes, programs, technologies, social workers, even personal paraprofessional helpers.

But conflict in the mental-health world centers on those not helped.

The U.S. Department of Education says 1 percent of children in school, about 800,000, are severely disturbed emotionally or mentally. But the U.S. surgeon general and repeated epidemiological studies say 5 percent, or 4 million children, is a conservative estimate, leaving 3.2 million unaccounted.

“Where are the rest of them? They are in regular classes in school, not getting the help they need, and causing a lot of difficulties,” said James M. Kauffman, professor emeritus of education at the University of Virginia and a leading authority on education and mental illness.

“The typical kid in special ed has been known to be emotionally disturbed for years,” he said, “maybe five or six years. Most are not caught early. Schools are loath to identify mental illness. Part of it is cost. Serving four to five times the number of kids we serve now means you would have to spend four to five times more money, and hire four to five times as many special ed teachers.”

“It’s not like we have people standing in line to have these kids in their classrooms,” said Rich Simpson, a researcher and professor of special education at the University of Kansas. “These are kids who spit and kick and cuss. They are the most neglected and the most poorly looked-after in the school system. They have the fewest advocates.”

Their educational fate, he said, is often bleak. “Unfortunately, they either drop out or are incarcerated or they sort of vanish,” he said.

Kim doesn’t want that for Holly. For months, she has struggled to convince school officials that putting Holly in an all-day regular classroom with 19 kids would be disastrous for everyone. She wants Holly to be taught in a special class with her own IEP.

But IDEA calls for disabled children to be taught in the “least restrictive environment” for numerous reasons. One is the belief that kids do better when taught alongside their peers and treated like everyone else.

Also: “We want to make sure we’re not putting kids into special classrooms that don’t need to be there,” said Jerry Keimig, the Lee’s Summit School District’s director of special services. “ED (emotionally disturbed) is a powerful label to put on a kid.”

Money, he said, is not a factor in deciding the best way to teach emotionally disturbed children. In the last decade, the district — like others locally and many nationally — has expanded services in response to a problem that is deepening more than it is growing, he said.

“The numbers aren’t the issue as much as the severity,” Keimig said. “They are much more severe. They have multiple diagnoses. Families are not becoming more functional, families and communities are becoming less functional. They bring all those issues to school.”

In response, each of the district’s 1,200 teachers is now required to go through Behavioral Intervention Support Team (BIST) training to learn how to calm kids before and when they fly out of control. Besides its special education classes, the district also has less restrictive alternatives: “buddy rooms” for overwrought kids to take a breather; “focus rooms” where kids can spend much or most of the day with specially trained teachers before returning to their regular classes.

The result, he said, is that fewer students, from 158 in 2000 to 110 now, are deemed emotionally disturbed. Nor are they put in special education classes which Keimig said should be “a last resort.”

Other districts are similar, hiring social workers and behavioral specialists, running individual and group counseling sessions. Earlier this year, the Hickman Mills School District teamed with Spofford to help identify kids with mental and emotional issues long before they erupt and to work with families to help keep their kids on track. The Kansas City, Kan., School District joined with the Wyandot Center for Community Behavioral Healthcare and began the Wyandot Academy, a school just for children with severe emotional disorders.

•••

Kim is worried. With Mrs. Sauve on the floor, Holly is happy. Everything about her, her smile, her eyes, her bushy hair, her energy, seems exaggerated, electric.

“Mrs. Sauve is in denial,” she’d say later. “They think if they give them TLC and love in the classroom, it will be OK. This is a mental-health issue.”

Holly’s IQ is barely 90. Her math and reading are at pre-kindergarten levels. “She can recognize about half of her kindergarten sight words,” Kim says. “After that, it’s guessing.”

She is bipolar and, because of it, takes lithium and Risperdal. She has a reactive attachment disorder, born of severe neglect as an infant.

In a healthy attachment cycle, infants discover, for example, that if they cry out of hunger or discomfort their needs are taken care of. They attach to other humans with a sense of trust and safety. But, the theory goes, if those needs go unmet or answered with blows, infants can view the world as unsafe. Instead of trust, they develop rage. They fight for their survival.

“She slapped a teacher last year,” Kim says of Holly. “She’s thrown desks. She swings her backpack and hits people, punches people. Any slight thing can send her into a tantrum — getting ready for school, brushing her hair.”

Just days ago, Holly returned home after three-months at Spofford, where doctors altered her medications and she was taught control.

It helped. When she entered Spofford in May, she erupted daily and often, as she did the day a dorm-mate got a new hairdo. Holly flung herself to the floor, pounded her hands and feet on the carpet, screaming, “I’m ugly!” because, she said, the other girl looked prettier.

Her fits have reduced. Spofford therapists now treat Holly at home. But Kim and her husband, Rick, are still worried.

Their experience with severely emotionally disturbed kids runs deep.

The couple (Kim works for the Midwest Foster Care and Adoption Association; Rick is a carpet layer) took in their first foster child, Mark, when their own kids, Kimmy, now 18, and Ricky, 16, were still in grade school.

After Mark, whom they eventually adopted, came 15 other kids, many emotionally disturbed.

The O’Neals got Holly in 2000 at 15 months old and officially adopted her two years later, along with her sisters, Brittney, now age 6, and Jamie, 14. Brittney has a mood disorder. Jamie, who suffered the longest and most abuse, has been living in residential treatment centers for the last four years.

“I want to prevent that as much as possible for Holly,” Kim says.

She’s not saying that getting Holly into a special class is going to solve all her daughter’s problems, or even the tiniest fraction. But for her the lessons are more fundamental: following directions, understanding consequences, controlling her behavior enough to stay in school.

Holly may seem fine in this moment with Mrs. Sauve, with all the attention trained on her. But Kim has little doubt what will happen in a class of 19.

“I give it one week before Holly does something big,” Kim says after Mrs. Sauve leaves.